Open Enrollment Tips

                                                                     

If you are one of the lucky employees who have a job and have health insurance soon you will be getting ready to participate in Open Enrollment.  Open Enrollment is an open benefits option for employees to make corrections or updates to their current health insurance benefits.  Health insurance companies are required to accept any changes or updates without questions or documentation of changes.  Health insurance benefits account for approximately 30% of an employee’s salary.

For those currently employed, you can make changes during your employers Open Enrollment which usually begins each year in October for:  prescription drugs, dental, health, flexible spending account, term life insurance, long-term care insurance and accidental death insurance but varies by employer.  Pick the options you know you will use.  Skip the ones you don’t need. 

To take full advantage of Open Enrollment, verify all of your information is accurate.  If you have benefits that will no longer be paid in 2012, ask your health plan provider if you can pay for the services using a Flexible Spending Account. Read all of the information provided to you prior to making any changes to make sure you pick the option that is best for you.

You may qualify for a health savings account (HSA) if your health insurance policy has a deductible of at least $1,200 for individual coverage or $2,400 for families.  Money is put in a pre-tax account which grows tax-deferred and can be used to pay for co-payments, deductibles, and other medical expenses. You can roll over the unused money each year and take the balance with you if you leave your job. Some employers contribute to employee HSAs. 

If you don’t qualify for a HSA you can sign up for a flexible spending account (FSA) which allows you to save money to pay for out-of-pocket medical expenses. In 2013, the maximum amount employees can contribute to a FSA will be $2,500 per year.  Your FSA contributions do not have to pay state and federal income taxes or Social Security payroll tax. The catch is you have to spend the remaining money by the end of the year or you lose the money.

How the Health Care Law Will Affect You in 2014

The Health Care Law is still alive and is the first major overall in the health care industry in the past 100 years.  Americans will have the option to shop for the same type of health insurance that Congress has which will reduce medical costs.  The health care law would reduce medical costs and out-of-pocket costs for middle class consumers and small business owners and reduce prescription drug costs for Medicare recipients. 

Over 40 million Americans are without health insurance and would be covered under the law which becomes effective in 2014.  Approximately 64 million women have no health insurance coverage, inadequate health care coverage, high medical bills or debt problems, or problems accessing health care because of the rising cost.  Health care insurance costs increase at a higher rate than inflation.  Consumers have longer appointment wait times, less service, less coverage and get sicker each year. 

Many people go into debt and have bad credit due to high medical bills because they do not have health insurance.  Health insurance reduces medical costs by from 50%-80%. An emergency room visit costs $500 or more without health insurance.  On average a doctor’s office visit can cost $130 for basic service without health insurance.  Purchasing Prevacid for acid reflux without health insurance can cost $176 for a 30-day supply.  If I didn’t have health insurance and only had to pay $95 that would be a small price to pay for medical services.  The $95 fee would pay for itself with just one doctor’s visit.

Health insurance companies will no longer be able to deny coverage based on pre-existing conditions, will be required to disclosure monthly premium increases and justify increases and will not be able to increase rates or cancel service if you get sick.  Health insurance companies will be required to offer coverage regardless of your health condition and cannot increases rates or cancel your coverage when you get sick.

Individual coverage monthly premiums will decrease by 14%-20% for self-coverage and decrease for individuals who receive coverage through their employer.  Over 50 million consumers will be able to receive free preventive services such as cancer screenings.  With these statistics I would rather be insured than not insured. 

17 Ways to Save on Medical Expenses

Each year many Americans file for bankruptcy due to medical debt. Over 40 million Americans do not have health insurance coverage. Many people are uninsured due to the high costs of medical coverage. Many employers only pay a small portion of healthcare costs leaving the remaining expense for the employee.

When a patient has health insurance there is a set limit that hospitals, doctors and other medical professionals can charge for services. Without medical insurance, a patient can be charged whatever fee the doctor or hospital chooses t for services and in some cases may be charged multiple times for the same services. The continual rising high school of medical season is due to the lack of mandated regulations in the health care industry, industry fraud and billing errors.

The United States has the highest incidents of high blood pressure, diabetes, heart attacks, stroke, and cancer. If you do not have health insurance always request an itemized list of the services you received to ensure there are no errors. Here are 17 ways to save on medical expenses.

1. Do research. Verify the medical provider is licensed.
2. Verify the agreement. Verify the agreement you establish with the medical provider in writing and make sure you understand the terms of the agreement.
3. Barter Services. Barter medic al services and goods. ITEX Corp. has 24,000 members where patients can exchange medical good and services for barter dollars but is usually limited to dental or smaller doctor practices. Visit barternews.com site for listings by state.
4. Negotiate with the service provider (doctor or hospital) to get fees reduced or eliminated in exchange for paying the debt.
5. Go to free dental clinics or free medical clinics for free or reduced dental services.
6. Go to a training school for services: dental school, barber school, cosmetology school, etc.
7. Participate in discounted dental programs.
8. Use Flat Fee clinics or sliding fee scale clinics.
9. Use Free or Reduced Healthcare.
10. Receive a Medicare supplement.
11. Buy generic prescriptions and get them filled at discount stores such as Wal-Mart, Target or Walgreens.
12. Manage medical expenses in a Healthcare Savings Account and order your own medical services (blood work, urine sample, etc.). Order test directly from the lab instead of your doctor ordering it for you.
13. HSA for America has a contract with Direct Labs to offer low prices to the HSA for America readers. It is free to join and members can order x-rays, lab tests, MRIs or CT scans.
14. Setup your own Health Savings Account if you employer does not offer one.
15. Participate in clinical trials that provide medication or services for medical issues you are experiencing.
16. Order blood test online and get results in 48 hours.
17. Give back. Refer your medical provider to others on the network or by word of mouth to friends, relatives and co-workers, this can help you negotiate future services needed by the same medical provider.

Health Care Reform Part II

According to the National Women's Law Center whether women are insured or uninsured, they have many out-of-pocket costs that they are more likely to avoid health care or struggle paying for health care. Some startling statistics regarding women and health care:

1. 33% of insured women and 68% of uninsured women do not get the care they need because they cannot afford it

2. 23% of insured men and 49% of uninsured men avoid health care because of cost

3. 16% of women are considered underinsured, while only 9% of men are considered underinsured

4. 38% of women struggle with medical bills compared with 29% of men

5. Women have less access to employer-sponsored insurance because they are more likely than men to work part-time

6. Women's access to insurance is less stable because they are more than twice as likely as men to get employer-sponsored insurance through their spouse

7. Women are more likely than men to take prescription drugs

8. 52% of women did not fill a prescription, did not see a specialist when needed, skipped a recommended medical test or treatment, or had a medical problem but did not visit a doctor compared to 39% of men

9. 45% of women had medical debt or reported problems with medical bills compared to 36% of men

10. 45% delayed or did not receive a cancer screening or dental care because of costs compared to 36% of men
Women will also be able to receive preventative medical services like immunizations and mammograms that will be covered in full by private health insurance companies and Medicare. Medicaid will expand services to new mothers and pregnant women, they will offer more family planning services, postpartum support and education and home visiting programs. Employers will be required to give nursing mothers breaks and space to pump breast milk.
Children with pre-existing conditions will now be able to receive health care coverage which is a huge victory since approximately 9 million children are uninsured. Health insurance companies will now allow young adults to remain on their parent's health plan up to age 26.

Older Americans will also receive additional help with prescription drug costs. Small business owners, many who are women will be able to provide health insurance to their employees and will be able to receive business tax credits. Starting in 2010 small business owners can get a 35% tax credit if they have 10 or less employee that earn less than $25,000 a year.

Beginning January 1, 2011, health insurance companies are required to waive co-payments and deductibles on preventive care which includes regular mammograms. Prescription drug companies will be required to provide a 50% discount on brand-name drugs bought in the coverage gap. The federal subsidy for Part D premiums will be reduced for higher-income beneficiaries. Cost sharing for preventive-care services will be eliminated.

A new temporary health insurance program will pay health insurance premiums and is available for retirees ages 55 through 64 who were laid off during the recession. In addition, health insurance companies will no longer be able to impose individual spending limits and terminate patients who have high medical costs.

Why Women Should Support Health Care Reform

Women should support the new health care reform for several reasons: 1) women usually make most of the decisions regarding family health care, 2) women usually live longer than men, 3) women usually require more medical care than men, 4) women have additional medical needs such as pregnancy, childbirth and childcare.

According to a report by the Commonwealth Fund, approximately 64 million women or 70%of Americans have no health insurance coverage, inadequate health care coverage, high medical bills or debt problems, or problems accessing health care because of the rising cost.

Many women have difficulty getting adequate health insurance because you usually need a full-time job which 52% of women versus 73% of men are likely to have. Many women continue to work full-time to continue receiving health care coverage but would prefer to work part-time or stay at home.

According to the Group Health Research Institute in Seattle victims of domestic violence have even higher health costs than other women for three years after the abuse ends totaling $1600 or more after the abuse ends.

According to a 2008 study by the National Law Center, prior to the health care reform, it was legal in most states for companies selling individual health policies to participate in gender rating by charging women more than men for the same coverage, even for policies that did not include maternity care. The health care premium differences ranged from 4% to 48%.

Health care reform will really help women because they can no longer be discriminated against and charged higher insurance premiums than men simply because they are a woman or for a pre-existing condition such as pregnancy, caesarian sections or other issues such as domestic violence and rape. Since women generally make only $.77 for every dollar men make, any reduction in health care costs is appreciated.

According to the National Women's Law Center whether women are insured or uninsured, they have many out-of-pocket costs that they are more likely to avoid health care or struggle paying for health care.

How the Healthcare Overhaul Affects You

Health insurance costs increase at a rate higher than inflation every year without a justifiable reason for the increase in costs. Subscribers do not get more coverage, better service, advise or quicker appointments. The Health care law that was signed on March 23, 2010 by President Obama will provide health insurance coverage to approximately 32 million Americans and guarantees that 95 percent of Americans will be covered.

In 2014, those Americans who don't get health insurance will have to pay $95 or 1 percent of their income, whichever is greater provided the amount does not exceed the cost of the health plan.

In 2016, those Americans who don't get health insurance will have to pay $695 per uninsured adult and can increase up to $2,085 per household or 2.5 percent of their income, whichever is greater. An adult would be penalized if they went more than three months of the year without health insurance. If your income is below a certain amount, or if the cheapest health insurance would cost 8 percent of the person's income, they would not be charged a penalty for lack of coverage.

Health insurance will be more affordable for the middle class and small business owners. The health care law would provide the largest cuts for the middle class which will reduce health care premiums and out-of-pocket costs. The law will also improve Medicare benefits by providing lower prescription drug costs.

Americans will also have the option to shop for the same type of private health insurance that members of Congress have which will reduce costs.

Health insurance companies will now be accountable by being required to keep premiums down and prevent healthcare coverage denials including pre-existing conditions. Health insurance companies will be required to offer coverage regardless of your health condition and cannot increases rates or cancel your coverage when you get sick.

There will be limits on how much is paid to receive health care coverage. Based on your income millions of Americans will get a tax credit to help pay for coverage.

If you like your current coverage you can keep it. If you have existing individual coverage on your own, your premiums would decrease by 14 to 20 percent and you may qualify for tax credits and will be provided better coverage.

If you get your health insurance coverage through your employer you will also see a decrease in premiums due to a reduction in administration costs and competition between insurance companies by up to 3 percent.

Insurance forms and health plan guidelines will now be written in plain english and forms will be standardized. Insurance companies that raise rates with no valid cause will not be able to sell their insurance poicies in the new insurance market.

Medical Bankruptcy Act

The Medical Bankruptcy Fairness Act of 2009 is a bill that would amend title 11 of the United States Bankruptcy Code (Bankruptcy Abuse Prevention and Consumer Protection Act of 2005) sponsored by Sen. Whitehouse which would: 1) provide protection for homeowners with medical debt, 2) restore bankruptcy protection for individuals experiencing financial distress who serve as caregivers to injured, ill, or disabled family members, 3) and to become exempt from taking the bankruptcy means test for those whose financial problems were caused by serious medical issues.

If the bill is passed it would waive the “means test” and credit counseling requirements for those who to wish file bankruptcy at a by hearing Sen. Russ Feingold (D-W.I.). Without health care reform, a family’s yearly health insurance payments could exceed $30,000 by the end of the 2020. Forty-seven million Americans are uninsured including 9 million children.

A recent study shows that based on the effects of the recession alone approximately seven million Americans will lose their health insurance coverage between 2008 and 2010. Researchers at the Urban Institute estimate that if unemployment reaches 10%, another six million Americans will lose their health insurance coverage. Employee spending on health insurance coverage has increased 128% between 1999 and 2008.

Economists have found that increasing health care costs show a connection with decreases in health insurance coverage. National studies show that the main reason many people are uninsured is due to the high costs of health insurance. According to the National Coalition on Health Care, a recent study found that 62% of all bankruptcies filed in 2007 were linked to medical expenses. Those who filed for bankruptcy, almost 80% had health insurance coverage.

A married couple lost their son to a fatal medical disease, in addition lost their home and their retirement income trying to pay medical bills related to their son's medical disease. Although they had health insurance, their health insurance company refused to cover all of their son's medical costs. They borrowed to file for bankruptcy. This is a clear example of why we need health care reform. Even if you don't support the president and don't support all of the features of the health care reform bill you must provide support to overhaul the current health care industry.

We are the only developed country that provides health insurance but have the largest number of deaths due to lack of medical insurance or lack of appropriate medical care.

The constitution states that "We the people of the United States… promote the generate welfare, and secure the blessing of liberty to ourselves and our Posterity…"

General welfare includes health care which as a country we are lacking in. How can health insurance companies claim that they will provide care for a patient yet deny them insurance because of a pre-existing, non-treatable or terminal condition. Health care is not about treating only healthy people, health care includes treating non-healthy people so they can become healthy.

The New Soda Tax

The Senate Finance Committee is considering imposing a new tax on soda and other naturally sweetened drinks to help pay for the Health Care Reform. The committee states the taxes would slow sales of unhealthy products that contribute to rising medical costs.

Thomas Frieden, director of the Centers for Disease Control and Prevention states that "obesity is a growing problem and taxpayers pay for half the cost through Medicare and Medicaid and soft drinks are the single largest contributor. A penny-an-ounce tax could reduce consumption by more than 10% and raise $100 billion over 10 years".

Early this year, a public uproar forced Governor Paterson of New York to abandon his plan for an 18% state tax on soda and other sugary drinks. Last year a proposal caused Maine voters to halt a plan that would impose a tax on soda. Arkansas, Missouri and California have considered the idea in the past.

This fall, San Francisco Mayor Gavin Newsom will introduce legislation that would charge a fee to retailers that sell sugary drinks. Mayor Newsom legislation would charge grocery stores but would not affect restaurants that serve sodas.

A September study released by UCLA showed a link between soda and obesity and found that: adults who drink at least one soft drink a day are 27% more likely to be obese than those who don't, soda consumption is fueling California's $41 billion annual obesity problem, 41% of children ages 2-11 drink at least one soda every day, 62% of teens 12-17 drink at least one soda every day, 39 pounds of sugar are consumed in a year if you drink one soda a day and 17 teaspoons of sugar is contained in a 20-ounce serving of soda.

President Obama has said he is open to the idea of a tax on soda and other sugary drinks. "I actually think it’s an idea that we should be exploring,” President Obama said in a recent interview. “There’s no doubt that our kids drink way too much soda."

Michael Jacobson of the Center for Science in the Public Interest stated that "soft drinks are the only food or beverage that has been shown to increase the risk of overweight and obesity, which, in turn, increase the risk of diabetes, stroke, and many other health problems".

Health care reform is expected to cost as much as $1 trillion over the next ten years. The Congressional Budget Office estimates that a three-cent tax on soda would generate $24 billion over the next four years.

According to the American Journal of Clinical Nutrition a 12 ounce soda has 150 calories and 40-50 grams of high fructose sugars equal to 10 teaspoons of sugar. Think twice before buying your next soda.

Paying Medical Debt

Medical debt is one of the reasons why Americans file for bankruptcy. Every year many Americans file for bankruptcy due to medical debt. In 2008, 46 million Americans did not have any health insurance coverage.

Many people are uninsured due to the high costs of medical coverage. Many employers only pay a small portion of healthcare costs leaving the remaining expense for the employee. It is expected that 1.4 million Americans will file for bankruptcy this year, and some will be due to medical debt.

Health care costs continue to increase each year. According to the National Coalition on Health Care, in 2008, total health care costs increased approximately 6.0% - almost twice the rate of inflation. In 2008, employer health insurance premiums increased by 5.0%. The annual premium for an employer health plan covering a family of four averaged nearly $12,700 versus $4,700 for individual coverage. Retiring elderly couples will need $250,000 in savings just to pay for the most basic medical coverage.

Many Americans file bankruptcy for various reasons such as job loss, illness, death of a loved one, disability, loss of coverage, divorce, and the additional medical fees associated with health care coverage such as co-payments, deductibles, prescription costs, COBRA costs, etc.

The problem is the lack of mandated regulations in the health care industry, industry fraud and billing errors. Health insurance companies over charge patients fees for services and if you do not have health insurance coverage you might as well sign over your child to pay for the medical costs because when you don't have insurance you can basically be charged whatever fee the doctor or hospital chooses. When you have health insurance you can only be charged a certain amount for services.

We claim to be the most powerful country in the world yet we are the sickest developed country in the world. We have the highest incidents of high blood pressure, diabetes, heart attacks, stroke, and cancer.

We should demand that full health insurance coverage is provided to all Americans no matter what their income or lack of income. You should not get better treatment or additional services simply because you have a higher income or can afford better coverage. Every human life should be valued but based on our health insurance industry it is not. We must fight back and force Congress to develop better laws to improve our health care industry and provide insurance for all Americans because we deserve it.